Predictive power of serum CA-125 and LDH in the outcome of first trimester pregnancies with human chorionic gonadotropin levels below discriminatory zone
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- Madendag, Y., Col-Madendag, I., Kanat-Pektas, M. et al. Arch Gynecol Obstet (2009) 279: 661. doi:10.1007/s00404-008-0798-x
The present study aims to investigate the predictive power of serum CA-125 and lactate dehydrogenase (LDH) for evaluating the outcome of first trimester pregnancies with beta human chorionic gonadotropin levels below discriminatory zone (≤1,000 mIU/mL).
A total of 107 women with tubal ectopic pregnancies (30 ruptured and 77 unruptured), 105 women with normal intrauterine pregnancies and 100 women with intrauterine abortions were eligible for the study.
Women with intrauterine abortion were found to have significantly higher CA-125 and LDH levels compared to women with ectopic and normal intrauterine pregnancies. Ruptured tubal pregnancies resulted in significantly higher CA-125 and statistically similar LDH levels compared with unruptured tubal pregnancies. Although CA-125 levels were found to be unrelated to gestational age in normal intrauterine normal and abortive as well as ruptured and unruptured ectopic pregnancies; LDH levels were directly correlated with gestational age in ruptured tubal ectopic pregnancies.
Consequently, the ability to determine the disintegration of ectopic trophoblastic or fetal tissues would be of great value in the management of hemodynamically stable patients with beta hCG levels below discriminatory zone. Intrauterine abortive pregnancies seem to yield high serum CA-125 concentrations combined with high LDH levels which indicate more extensive trophoblastic tissue damage than caused by intrauterine and ectopic pregnancies.